Person-Centered Multimorbidity Care in UK Primary Care: Identifying Changes to Practice

Area of Science:

• Primary Care
• Health Services Research
• Patient-Centered Care

Background:

• Multimorbidity, defined as two or more long-term conditions, affects a growing population.
• Current healthcare delivery models struggle with the complexity of managing multimorbidity.
• A shift towards whole-person, tailored primary care is advocated but lacks implementation details.

Purpose of the Study:

• To systematically identify enablers and barriers to delivering tailored primary care for multimorbidity.
• To develop a new model for implementing whole-person tailored care in primary care settings.

Main Methods:

• Ethnographic observation of 25 consultations across 5 UK general practitioner sites.
• Focus group discussions with primary care staff (n=16) and patients/carers (n=8).
• Inductive thematic analysis of integrated qualitative data.

Main Results:

• Key enablers include resources for tailored assessment and support.
• Patient and carer engagement with professional collaboration is crucial for co-creating management plans.
• Developing professional skills to move beyond condition-focused care is essential.

Conclusions:

• Whole-person tailored care requires integrating more services into primary care.
• A cultural shift towards shared decision-making among multidisciplinary teams, patients, and carers is vital.
• Flexible consultation models and continuous learning, supported by monitoring, are necessary for effective implementation.